Mentally ill juveniles cycle in and out of detention

Every year in the Northwest, thousands of mentally ill teenagers get caught up in the juvenile justice system. In fact, some counties estimate more than half of the kids they place behind bars have a diagnosable mental health condition like schizophrenia, bi-polar or personality disorder. Yet many of these teens do not get the treatment they need. Instead, they cycle in and out of detention.

Cycling in and out

The first thing you notice about 16-year-old Jordan -- we’re just using his first name -- are his ears. Actually his earlobes. They’ve got big holes in them -- tribal style. He’s stretching them to fit large decorative rings.

“I’m going to an inch,” Jordan says.

It looks painful. And I ask him why he’s doing this.

“It’s the thing about being different,” he responds. “I like being different.”

When he was younger, Jordan says being different meant he got picked on and bullied at school. One day he’d had enough.

“So I brought a knife to school and I pulled a knife on two different kids.”

He was charged with assault and put on probation. But the trouble didn’t stop there. Jordan says back then he was full of rage.

“You know I grew up and I got bigger, so I became the bully,” he says.

He committed another assault and another. He also drank and took drugs. Jordan cycled in and out of juvenile detention. A place called Martin Hall near Spokane.

He says it was a “cake walk.”

“Martin Hall is nothing to me. It’s just somewhere to catch up on some lost sleep,” Jordan says. “And they just kept sending me there. It was like they didn’t even care.”

Now there’s something you need to know about Jordan. At an early age, he was diagnosed with clinical depression. Later, he experienced drug induced psychosis. This doesn’t excuse his criminal behavior. But here’s the thing, at Martin Hall he says he didn’t get any treatment for his mental health issues.

“Not really. You know they gave you your meds in the morning that you were taking on the outside,” he explains.

I ask, “Did you have mental health counseling sessions, did you have group therapy? Anything like that?”

“Not that I can remember.”

Inadequate Facilities

Officials at Martin Hall confirm they do not have a mental health professional on staff. Most county juvenile lock ups don’t.

“This is not a place for kids who have serious mental illnesses,” says Mark Tips who runs the juvenile detention center in Thurston County -- in the shadow of Washington’s state capitol. As he gives me a tour, he’s blunt.

“There are no treatment options here. It’s a jail, it was built as a jail and not as a treatment facility,” he says.

And yet, says Tips, county lock ups like his have become “dumping grounds” for mentally ill youth. Sometimes, he says, juveniles show up here who just the week before were declared not competent to stand trial.

“Kids with substantial problems who we can maintain here safely, maintain securely, but who cannot and will not get better from anything that will happen here.”

Tips says the problem is simple: mental health services in the community are inadequate.

“Without a doubt if we had more funding and more clinicians and lower caseloads we could improve on the system,” he says.

But Freedman says there are other barriers to getting a kid help before he ends up cycling through juvenile detention. For one, usually only Medicaid eligible youth qualify for services. And then it’s purely voluntary.

“Even if they are referred, if the child and the family does not want to participate in treatment, we can’t make them,” Freedman explains.

Freedman says ideally you start treatment when the kid is in jail because you’re more likely to get buy in.

But there’s a problem. Medicaid doesn’t cover kids who are locked-up. That means sometimes these youth don’t get the help they need until after they’re convicted of a crime and either sent up to a state juvenile facility or put on probation.

“I think that we all have cases on our caseload where clearly if the right services were made available to that youth before they started acting out that they would not be involved in the criminal justice system,” Herbert says.

Herbert tells me about a teenage girl who was sent to live in a group home. There she repeatedly assaulted staff or damaged property. Each time the cops were called and the girl cycled in and out of juvenile hall.

Herbert says, “It was at least eight times.”

But it wasn’t until she tried to commit suicide that she finally got help.

“Unfortunately it was after many, many months of accumulating criminal history, of frustration I’m sure on her part as well as the community’s part in trying to protect her, in trying to protect others,” she says.

That teenager is currently getting in-patient psychiatric care. But that’s a last resort and those beds are few and far between.

An alternative option

Eric Trupin is a child psychologist at the University of Washington. He says the system should be catching these kids before there’s a crisis. He’s an evangelist for evidence-based intervention programs that involve all the adults in a kid’s life who then come up with an individualized care plan for the youth.

The term is wrap-around services.

“Sort of thinking about what’s going on in that youth’s environment that could be modified or changed to really improve the outcome,” Trupin says.

Trupin runs something called Family Integrated Transitions or FIT. It’s a combination of several evidence-based programs for kids like Jordan with both mental health and drug or alcohol problems. Studies show FIT and other intensive wrap-around programs for juveniles could actually save Washington from having to build a prison in the future.

But these services are not widely available. In fact, state figures show last year evidence-based programs served just one-quarter of the Washington youth who were eligible. Trupin calls it “outrageous.”

He says he’s watched kids who cycle in and out of detention become “hardened individuals with despair and misery and little hope that they’re going to have effective lives.”

The issue, of course, is funding. Traditional one-on-one counseling is cheaper than evidence-based wrap-around programs. As for Jordan, he’s been in both.

Now he’s in Trupin’s FIT program. There are no guarantees. But for the first time since he was 11, he’s stayed out of trouble long enough to get off juvenile probation.

“It’s my mindset,” he says. “I’ve changed my way of thinking. I don’t have to be that, pardon my language, ‘Billy Bad Ass’ any more, I don’t have to be that guy.”

This January, Washington State Representative Marylou Dickerson, a Seattle Democrat, will introduce legislation to expand the availability of evidence-based programs in Washington. She’ll make the case that it makes sense in a tight budget to invest in what’s been proven to work.